title: The sustainability of a community pharmacy intervention to improve the quality use of asthma medication.
abstract: OBJECTIVE
  A previously published asthma intervention used a software application to data mine pharmacy dispensing records and generate a list of patients with potentially suboptimal management of their asthma; in particular, a high rate of provision of reliever medication. These patients were sent educational material from their community pharmacists and advised to seek a review of their asthma management from their general practitioner. The intervention resulted in a 3-fold improvement in the ratio of dispensed preventer medication (inhaled corticosteroids) to reliever medication (short-acting beta-2 agonists). This follow-up study aimed to determine the long-term effects of the intervention programme on the preventer-to-reliever (P:R) ratio.
  
  
  METHODS
  The same data mining software was modified so that it could re-identify patients who were originally targeted for the intervention. Community pharmacists who participated in the previous intervention installed the modified version of the software. The dispensing data were then de-identified, encrypted and transferred via the Internet to a secure server. The follow-up dispensing data for all patients were compared with their pre- and post-intervention data collected originally.
  
  
  CONCLUSIONS
  Of the 1551 patients who were included in the original study, 718 (46·3%) were eligible to be included in the follow-up study. The improved P:R ratio was sustained for at least 12 months following the intervention (P < 0·01). The sustained increase in the P:R ratio was attributed to significant decreases in the average daily usage of reliever medication (P < 0·0001).
  
  
  CONCLUSIONS
  The follow-up study demonstrated a sustained improvement in the ratio of dispensed preventer medication to reliever medication for asthma. The intervention has the potential to show long-lasting and widespread improvements in asthma management, improved health outcomes for patients, and ultimately, a reduced burden on the health system.
authors.affiliation: Unit for Medication Outcomes Research and Education, School of Pharmacy, University of Tasmania, Hobart, Tasmania, Australia. Bonnie.Bereznicki@utas.edu.au
authors.forename: B
authors.initials: B
authors.lastname: Bereznicki
authors.forename: G
authors.initials: G
authors.lastname: Peterson
authors.forename: S
authors.initials: S
authors.lastname: Jackson
authors.forename: E H
authors.initials: EH
authors.lastname: Walters
authors.forename: P
authors.initials: P
authors.lastname: Gee
mesh_terms: D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000453:epidemiology; D003157:Community Pharmacy Services; D057225:Data Mining; D005500:Follow-Up Studies; D006801:Humans; D010353:Patient Education as Topic; D010594:Pharmacies; D055553:Prescription Drugs / Q000627:therapeutic use*; D015397:Program Evaluation; D058996:Quality Improvement; D012984:Software; D016896:Treatment Outcome
chemical_list: D018927:Anti-Asthmatic Agents; D055553:Prescription Drugs